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Advocates, physicians call NOPAIN Act ‘game changer’

Along with causing a crisis of its own, the COVID-19 pandemic, which has now impacted the nation for roughly nine months, has exacerbated longstanding crises in healthcare, employment, housing and education.

The opioid epidemic is no exception.

While the U.S. saw a 2.9 percent decrease in drug overdose deaths between February 2018 and February 2019 compared to 2017, an Office of National Drug Control Policy report stated that overdose deaths likely increased by 16 percent between January and April of this year compared to the same period in 2019.

The COVID-19 pandemic has created the perfect storm for opioid abuse, and the catastrophic effects that come with it, to proliferate – many hospitals have canceled elective surgeries and prescribed painkillers to help see patients through the pandemic and people struggling with addiction have faced myriad struggles, from isolation to job loss and more, making it more difficult to stay sober.

For U.S. Rep. Terri Sewell, D-AL, one way of addressing the opioid crisis, brought before the House long before the coronavirus emergency, was through the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, a bipartisan piece of legislation that provides broader access to non-opioid alternatives, which not covered by insurance and extremely cost-prohibitive.

An array of organizations have lined up to support the legislation, in the form of a coalition known as Voices for Non-Opioid Choices, with physicians and advocates alike hailing it as a “game changer.”

Katie Beckham, a board member for the Alabama Society of Physician Assistants, said the opioid crisis is an issue “near and dear to her heart,” as she deals with narcotics on a regular basis working in orthopaedic surgery.

While Beckham noted that some patients need opioid medications, she said the risks often outweigh the benefits, particularly when it comes to seniors struggling with pain.

“I think that’s where these alternatives come in,” Beckham said, noting that she uses an injectable one on patients that lasts up to five days after a surgery.

Beckham said wider access to the alternative pain management treatments has the potential to reduce health complications and  hospital stays, but many hospitals don’t offer such alternatives.

“Currently, it’s really facility-dependent if you have access to some of these drugs, because it’s an issue of cost,” Beckham said. “By having some of these alternatives out there, that could eliminate turning to narcotics.”

Beckham noted that, while a Tylenol costs only cents in the hospital,  an injectable form of the drug – one alternative to opioids – is as much as $15 per injection while Percocet remains “absurdly cheap.”

“I think by this bill being passed, we’re going to encourage other people in the industry to come out with new medications to bridge this gap,” Beckham said.

For Lisa Bright, the crisis is just as real.

Bright launched the Will Bright Foundation with her husband after their son died of a heroin overdose in 2012 at the age of 25 – his introduction to opioids was an old prescription left behind at a friend’s house.

Bright said she and her husband opted to “turn [their] pain into purpose” by working with addicts and providing them with job training and counseling.

But pandemic isolation is a real threat and, working in West Alabama, Bright has struggled to keep up with the need.

“Through the pandemic, it’s caused us to have almost a stop and a pivot as our guys aren’t working,” Bright said. “They’ve lost hours because of the pandemic and through isolation we’ve seen increases in overdoses. In rural West Alabama, we have not been able to do the Zoom meetings because we don’t have internet at our facilities.”

And it’s not just the current crisis Bright is concerned with.

“It’s really going to be affecting our children,” Bright said. “And if we don’t get ahold of this opioid addiction, it’s going to be worse because of the pandemic.”

Bright said Sewell’s bill would dramatically decrease the amount of opioids in circulation, thereby making it more difficult for young people – like her son – to get started.

For Gerald Fraas, who founded Students for Opioid Solutions at the University of Alabama (UA) after losing a close friend to an overdose, crushing the supplyline is one of the bill’s best features.

“It’s better to address it while you’re still able to, rather than when you have to or you can’t,” Fraas said.

While Fraas noted that additional efforts have to be undertaken to eradicate the opioid epidemic, such as destigmatizing addiction so that people are no longer ashamed to seek help, he noted that a “top-down” reduction in supply would have a huge impact.

“We can do better – we can help patients get the care they need while, at the same time, ridding our communities of excess pills that oftentimes lead to misuse and diversion,” said Voices for Non-opioid Choices Executive Director Chris Fox when the legislation was introduced.   This legislation will go a long way towards reducing rates of opioid addiction in this country by properly incentivizing the use of non-opioid pain management approaches.”